全自动血凝仪定量检测D-二聚体两种试剂的比较研究

A comparative study on the quantitative detection of two reagents of D-Dimer by automatic coagulation analyzer

目的:探讨全自动血凝仪ACLTOP-700免疫比浊法快速定量检测D-二聚体(D-Dimer)两种试剂的比较,借以判断两种试剂的优劣。方法:选取532例住院患者,其中不稳定心绞痛患者388例,肺栓塞患者60例,冠状动脉硬化患者70例,腹主动脉瘤患者14例,其余为高血压和冠心病患者。抽取所有患者静脉血于ACL-TOP上分别使用D-二聚体测定试剂盒D-Dimer和D-DHS两种试剂检测D-Dimer含量。结果:D-Dimer检测结果均有不同程度的增高,其中假阳性病例88例,纤维蛋白降解产物(FDP)和D-Dimer同时检测单项D-Dimer升高者,且无任何临床症状,均由VIDAS仪器检测平台进行验证。D-Dimer试剂检测D-Dimer的结果为1594.15±2286.18,D-DHS试剂检测D-Dimer的结果为912.97±1814.06,两者有显著差异(t=3.654,P<0.05)。两种试剂的一致性较差,其相比有差异(r=0.419,P<0.05)。结论:全自动血凝仪ACLTOP免疫比浊法快速定量检测D-Dimer,D-Dimer和D-DHS两种试剂比较,D-DHS试剂排除假阳性的能力明显较强,且对黄疸、溶血和乳糜血的抗干扰能力较强。

Objective To investigate the detection ability of two reagents by automatedcoagulation analyzer ACL-TOP using immune turbidimetric method, and to determine themerits and demerits of them. Methods： Two reagents were compared in the study. We selected532 cases of hospitalized patients in Anzhen Hospital, 388 cases of which were unstable angina, 60 cases werepulmonary thromboembolism, 70 cases were coronary atherosclerosis, 14 cases were abdominal aneurysm, and the restwere the patients with high blood pressure and coronary heart disease. The plasmas of all the patients were extracted,and D-dimer was detected on ACL-TOP by D-Dimer （referred to as reagent A） and D-DHS （referred to as reagentB）. Results： The results of D-dimer increased in different degrees, and there are 88 cases of false positive cases. Thecase whose FDP and individual D-dimer of D-dimer simultaneous detection was elevating and clinical symptoms weredisappeared was detected by the VIDAS instrument platform verification. There were significant differences betweenA and B. The detection result of reagent A was [1594.15±2286.18], and reagent B was [912.97±1814.06]. There weresignificant differences between them （t=3.654, P〈0.05）. In addition, the consistency of the two reagents was poor（r=0.419, P〈0.05）. Conclusion： Comparing two reagents to detect D-dimer quantitatively by automated coagulationanalyzer ACL-TOP, D-DHS owns greater ability to exclude false-positive results, so does the ability of anti-interferencewith jaundice, hemolysis and chylemia.